Bio Medical Waste Planning and Management Dr Vaibhav

Bio Medical Waste: Planning and Management Dr. Vaibhav Goel Bhartiya Subharti Law School Swami Vivekanand Subharti University Meerut

What are the minimum requirements for health? • Availability public health care facilities must exist in sufficient quantity. At a minimum, this includes safe drinking water, adequate sanitation, hospitals and clinics, trained medical personnel receiving domestically competitive salaries, and essential drugs • Accessibility health care must be physically and economically affordable. It must be provided to all on a non-discriminatory basis. Information on how to obtain services must be freely available. • Acceptability all health facilities must be respectful of medical ethics, and they must be culturally appropriate • Quality health facilities, goods, and services must be scientifically and medically appropriate and of good quality. At a minimum, this requires skilled medical personnel, scientifically approved and unexpired drugs and hospital equipment, safe water and adequate nutrition (within the facility)

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Bio medical waste • waste means ‘res derilicta’ (or the abandoned object) corresponds to the concept of “ throw away” culture. • Bio-medical waste is a term coming into common usage to replace what had been referred to as pathological or infectious wastes and to include additional related waste streams.

• Bio-Medical Waste" means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining thereto or in the production or testing of biological. It includes infectious and non-infectious waste. Infectious waste includes pathological waste, cotton, dressing, used needles, syringes, scalpels, blades, glass, etc. , and non-infectious waste includes general waste from the kitchen / canteen, packaging material including radioactive wastes, mercury containing instruments, PVC plastics ”

• In true sense and in the manner we understand biomedical hazards in modern time had been arisen in USA during 1970 s period. The eye opening incidences had been occurred at the East Coast of the USA where medical waste mixed with the municipal waste stream had found including syringes and bandages were washed up on beaches in the East Coast of the USA. • A Report on Alternative Treatment and Non-Burn Disposal Practices, A WHO publication Pg. 4. See, www. searo. who. int/Link. Files/SDE_mgmt-bio-medical -framework. pdf.

• It is estimated that Delhi produces 7, 000 metric tones of waste every day. Biomedical waste generated by 1, 700 healthcare establishments is 80, 880 kg of waste per day in Delhi only. As per Indian Express. com. feb 08, 10 available at, http: //www. w 3 c. org/TR/1999/REC-html 40119991224/loose. dtd accessed on 27. 12. 2010.

Why special planning for Bio Medical Waste • First, the Bio-medical waste itself is the different kind of waste and cannot be treated and manage on the same footing as other waste materials are! The other waste material which is not useful may not be as dangerous as the Bio-medical waste. • Secondly, the Bio-medical waste is vulnerable and contagious and the person coming in contact may get infected due to it. Thus the contagious and infectious nature of the bio-medical waste itself reveals the danger of mismanagement Continued…

• Thirdly, the Bio-medical waste cannot be destroyed as easily as the other waste can be destroyed. The products used for medical treatment of human body are made up of such material which cannot be decomposed easily. Again the bacteria, virus, fungus or any biological infectious micro-organisms are resistant to different normal process of immunization by heating, boiling and dumping. These microorganisms are capable of surviving years together unless destroyed thought specific treatment.

• Lastly, as the micro-organism of diseases carries by Bio-medical wastes may infect to even healthy human being respective of his resistance power, age or even the area. • Therefore, handling, disposal and destruction of hazardous waste including Bio-medical waste has become task of top-priority for the urban societies and improper disposal of such waste material has become one of the biggest challenge for present developed and developing nation.

Effects of Bio-medical • 1. Infection. • 2. Genotoxicity and Cytotoxicity • 3. Chemical toxicity • 4. Radioactivity hazards. • 5. Physical injuries • 6. Public sensitivity.

There are two main types of risks associated with biomedical waste. • Foremost is the risk to health, due to infection or injury, particularly health care workers involved in handling of biomedical waste. • The second types of risk are an environmental risk, if there is no proper disposal of biomedical waste. This can lead to pollution of water, air and soil resulting in long-term exposure of the population which may lead to server adverse health effects due to poisoning The risk to water can be due to heavy metals, such as mercury, silver or expired pharmaceuticals for disposal

• Unscientific disposal of health care waste may lead to the transmission of communicable diseases such as gastro-enteric infections, respiratory infections, spreading through air, water and direct human contact with the blood and infectious body fluids. These could be responsible for transmission of Hepatitis B, C, E and AIDS within the community. Diseases are spread by improper treatment and disposal of waste.

Indian Legislation on the issue • 1989 the Government of India, in exercise of powers conferred under Section 6, 8 and 25 of the Environment Protection Act, 1986 formulated the Hazardous Waste (management & Handling) Rules, 1989 but hospital waste is not covered in this. • It is only in 1995 the legislative response came out when government had taken the feedback from the public on Bio-medical Waste after issuing a draft because of Basel.

• Biomedical Waste (Management & Handling) Rules, 1998" (BMW Mgt) in short) in July 1998 has been finally notified. • In accordance with the rules, every hospital generating BMW Mgt needs to set up requisite BMW treatment facilities on site or ensure requisite treatment of waste at common treatment facility.

Paschim Banga Khet Mazdoor Samity and others v. State of West Bengal and another, AIR 1996 SC 2426 and in W. L Wadhera vs. Union of India • All hospitals with 50 beds and above should install either their own incinerator or an equally effective alternative method before 30 th November 1996. • The incinerator or the alternative method should be installed with a necessary pollution control mechanism conforming to the standard laid down by Central Pollution Control Board (CPCB). • Hazardous medical waste should be segregated at source of generation and disinfected before final disposal.

Bio-medical waste generation & disposal : Problems • • – Improper waste management: The waste management of the primary health care institution is negligence on their part and which raise the bio-medical waste scatter on the road or in public space, which harm to animal as well as environment. – Lack of proper knowledge: There is lacking of proper knowledge to disposal of the biomedical waste and proper management so it raise to BMW – Cost of disposal: There is cost of bio-medical waste on the hospital Authority so they neglect on there part and small clinic are not offered that cost. – Absence of any heavy punishment: There is no any provision in law to give heavy punishment to the violence that rule and very light punishment are mention

Some of the object of BMW Rules • • • Health and safety of the nurses staff Management of Waste in Health Care Institution Prevent Transfusion of diseases and deficiencies Proper Disposal of Bio-medical Waste To prevent injury to the health care workers To prevent general exposure cytotoxic, genotoxic and chemical • Get seriousness about Bio-Medical Waste • Punishment or penalty provided to violating the rule of BMW to the occupier or the operator. • Maintain the record the bio-medical waste (end of year 31 st of December and display at 31 st of March of every year. )

• But after the empirical study I came across that no where rules have been followed properly. • Health care unites are transmitting the same rules of 1998 as amended in 2000 on their web site or otherwise but working practically on that. • Hence the problem of Bio medical waste increasing with the development of technologies and procedure of disease eradication.

Suggestions • It is utmost necessary to have ample literature (in reach) on the bio-medical waste management • It is also necessary to have the linkage between various institutions, organization and governmental bodies working in bio-medical waste management • While granting the permission to the hospitals, norms shall be developed so that at the initial stage the hospital may have infrastructure for bio-medical waste management at their site • There is urgent need to have more numbers of disposal sites in the metro cities. • It is further recommended that through there is not need of any modification or alteration in the present piece of legislation, but its effective execution is urgently warranted which is possible through Public Participation only

• • • It is further recommended that the bio-medical waste hazards shall also be looked from the “Health” jurisprudence. At the present the judicial decisions are focusing only on the “environmental” aspects in its decisions. But bio-medical waste not only has the impact on “environment” but also on the Health of an individual and community health as well. Management. The increasing participation from the NGOs, international institutions, local bodies, voluntary organizations shall be given priority so that the policy execution burden may be shared and distributed upto larger extend. Monitory Guarantee may be imposed on Hospitals

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